Common cancer in HIV-infected persons. Incidence has fallen since the introduction of HAART. It is caused by infection with human herpes virus type 8 (HHV8).
Was thought to be primarily via anal intercourse in homosexual men, but it is likely that transmission is via salivary route in susceptible people. In Europe, it is commonly seen in the legs in men but in HIV- infected women in Africa, it is seen equally in both the sexes and also in children and adolescents.
AIDS-related KS presents with widespread lesions in the skin and mucus membranes. The skin lesions are seen as red or purplish macules or nodules that may bleed and ulcerate and usually increase in size and number with time. The lesions may coalesce to form plaques of tumor. Depending on the immune status of the patient, it may be slow growing or progress rapidly to systemic disease .
Extracutaneous sites include the oral cavity, gastrointestinal tract (causes obstruction and bleeding), lymph nodes (local edema), and lungs (causes breathlessness and cough).
Biopsy of skin or other lesions.
Cosmetic for unsightly lesions, palliation of painful lesions and systemic disease.
: radiotherapy — Kaposi's sarcoma is markedly radiosensitive and small doses cause regression in up to 70% of patients. Single doses are also effective, and superficial irradiation delivering 8Gy to symptomatic sites is recommended.
Other modalities are: excision, cryotherapy, laser treatment, photodynamic therapy, and intra lesional Vinblastine.
: for widespread, bulky, or progressive disease, liposomal doxorubicin and paclitaxel are quite effective.
Woodruff R, Cameron D. HIV/AIDS in Adults. Hanks G, Cherny NI, Christakis NA, Fallon M, Kaasa S, Portenoy RK (Ed).Oxford Textbook of Palliative Medicine. Oxford University Press, 4th ed. 2010, pp.1195-1230.